Contributors DH was involved in the planning of the evaluation, monitored and involved in the collection of data, cleaned and statistically
analysed the data, and drafted and revised the paper. DM was involved in developing and implementing the original recall strategy
and revised the draft paper. JJ managed the daily operation of the recall strategy in terms of identifying eligible MSM and
recalling them and collected and recorded data for the evaluation. PB was involved in developing and implementing the original
recall strategy, planning and supervising the evaluation and revised the draft paper.

Accepted 31 August 2011

Published Online First 28 September 2011

Abstract

Objectives To assess the feasibility and outcomes of recalling men who have sex with men (MSM) diagnosed as having a bacterial sexually
transmitted infection (STI) for re-screening.

Methods This evaluation was conducted from December 2008 for a 9-month period. MSM diagnosed as having a bacterial STI in that period
were offered recall for re-screening 3 months after their diagnosis. Re-screening rates and infection incidence were calculated.
Differences in baseline characteristics by re-screening status and factors predictive of infection at re-screening were assessed
using the Mann–Whitney test, χ2 test and logistic regression.

Results Of the 337 MSM diagnosed as having a bacterial STI, 301 were offered recall. Of these, 206 (68.4%) re-screened after 3 months,
30 (10%) declined and the remainder did not re-attend despite giving verbal consent. Compared with those not re-screening,
those re-screening were less likely to be HIV positive (p=0.001), but there was no difference in baseline risk behaviours.
There were 15 diagnoses of bacterial STIs at re-screening (29 per 100 person-year follow-up (pyfu); 95% CI 14.3 to 43.7) and
five new HIV diagnoses of whom three had a negative test at baseline, one tested negative 6 months earlier and one never tested.
Among those testing at both time points, the HIV incidence was 8.3 per 100 pyfu (95% CI 0.0 to 17.7).

Conclusions This evaluation demonstrates a ‘recall for re-screening’ strategy is feasible in terms of high re-screening rates and incidence
of new infections diagnosed. Experimental evidence is needed to assess cost-effectiveness and whether it achieves its aim
of reducing transmission of STIs and HIV.

Footnotes

Funding Camden Primary Care Trust was the funder of all services at Mortimer Market Centre. They provided extra funding for this
new service strategy to be rolled out in the service. This extra funding was used to cover employ an extra health advisor
to run the service.

Competing interests None.

Ethics approval Ethics approval was not deemed to be required by the local research and development department as this was an evaluation
of a service delivery.